The American Indian Research Group in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine proposes to investigate the development of urban American Indian adolescent alcohol and drug use/abuse, and to identify new knowledge useful in developing prevention interventions with problem drinking and drug abusing American Indian youth. This prospective, longitudinal cohort design with multiple assessments across years is comprised of 350 urban American Indian adolescents and their mothers or primary caretakers drawn from a total population of 600. Data also will be collected from two additional cross- sectional samples, each comprised of 100 sixth and ninth grade subjects and their mothers. During a five year period, we will assess the antecedents and consequences to alcohol and drug use by collecting data in the following nine domains (areas of research interest): alcohol use, drug use, sociodemographic history, neuropsychological screening, school-academic, internalization, externalization, family and peer environment, and family history of alcohol use. Specifically, the project's aims are: 1) To describe the prevalence and change over time of alcohol use, drug use, and problem drinking behaviors; 2) To investigate the processes of substance initiation and problem drinking onset by identifying the risk and protective variables that promote or inhibit initiation and abuse; 3) To develop a screening battery for early identification of alcohol and drug abusing urban American Indian adolescents; and 4) To continue to disseminate clinically relevant information to health care providers within American Indian, academic, and social service systems. The proposed project represents our next step in the scientific study of American Indian alcohol and drug abuse from a perspective that remains relevant to the clinical concerns of Indians while relying upon Indian participation through all phases of the project. The knowledge to be gained from the project is vital to the development of services which can reduce the prevalence of alcohol and drug abuse among American Indians, the ethnic group in America at greatest risk for alcoholism and drug abuse. This project initiates a long term study of the natural history of alcohol and drug use within an urban American Indian population.